What is osteoarthritis?

Osteoarthritis: Overview

Arthritis, also called osteoarthritis, is a breakdown of the cartilage that cushions your joints. When the cartilage wears down, your bones rub against each other. This causes pain and stiffness. Many people have some arthritis as they age. Arthritis most often affects the joints of the spine, hands, hips, knees, or feet.

Arthritis never goes away completely. But medicine and home treatment can help reduce pain and help you stay active.

Osteoarthritis

Osteoarthritis is usually called arthritis. Many people get this type of arthritis as they age. It happens when the cartilage that cushions your joints—like your knees and hips—gradually breaks down. Then the bones rub against each other. This causes damage and pain. There are many treatments that can help with the pain and make it easier to move.

What happens when you have osteoarthritis?

It's hard to know if and how fast arthritis will get worse. Symptoms may come and go, stay the same, or get worse over time.

At first, you may have pain only when you are active. Over time, you may also have pain when you are resting. Joints can become stiff, and you may lose the full range of motion you used to have. Joints can become misshapen over time. This is more likely in the small joints of the hands and feet.

Although there is no cure for arthritis, treatment can help slow the disease and relieve symptoms. Most people can manage their symptoms with medicine and lifestyle changes. But in a few people, arthritis may get so bad that they decide to have surgery.

What are the symptoms of osteoarthritis?

When you have arthritis, even simple, everyday movements can hurt. Walking a few steps, opening a door, and even combing your hair can be hard. Symptoms may be mild to severe and may include:

  • Pain in your joints.
  • Stiffness when you get up in the morning.
  • Muscle weakness around the joints.
  • Swelling in the joints.
  • Joints that are deformed and look like they are the wrong shape.
  • Reduced range of motion and loss of use of the joint.
  • Cracking and creaking in your joints.
  • Sleep problems.

You can have symptoms in any joint. But they most often occur in the hands, hips, knees, feet, and sometimes the spine. Most often, arthritis only occurs in one set of joints, such as the knees. But it may affect more than one area of the body, such as both the knees and the hands.

How is osteoarthritis treated?

Treatment for arthritis includes pain medicines and self-care. Self-care includes exercise and activity, staying at a healthy weight, putting ice or heat on a sore joint, and resting. For severe arthritis, surgery is an option.

How can you prevent osteoarthritis?

You can take steps to help prevent osteoarthritis. For example, stay at a healthy weight, be active, and protect your joints. If you already have arthritis, these same steps may keep it from getting worse.

How is osteoarthritis diagnosed?

Your doctor can often diagnose arthritis by asking you questions about your joint pain and other symptoms and examining you. You may also have X-rays and blood tests. Blood tests can help make sure another disease isn't causing your symptoms.

How are medicines used to treat osteoarthritis?

Medicine can help reduce your symptoms of arthritis and allow you to do your daily activities. But medicine doesn't cure arthritis or slow the time it takes for cartilage to break down.

Medicines that work for some people don't work for others. Be sure to let your doctor know if the medicine you're taking doesn't help. You may need to try several kinds of medicines to find one that works for you.

The goal of medicine is to:

  • Manage pain with the fewest side effects.
  • Keep your joints working and moving well. If pain keeps you from moving your joints, it can cause the ligaments, tendons, and muscles that move your joints to shorten and become tight and weak.

The type of medicine depends on how bad your pain is. For example:

  • For mild to moderate pain, you can try over-the-counter pain medicine. These include nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil or Motrin) or naproxen (Aleve). Acetaminophen, such as Tylenol, may also help.
  • For moderate to severe pain, you may need stronger pain medicine, such as opioids.

Medicine choices

Medicines used to treat arthritis include:

  • NSAIDs to reduce pain and swelling.
  • Acetaminophen to help relieve pain.
  • Tramadol to help relieve pain.
  • Steroid shots in the joint to reduce swelling.
  • Some antidepressants, such as duloxetine, to help relieve pain.
  • Opioids to relieve severe pain.

Medicine that you put on your skin (topical) may relieve pain for a short time. These include topical NSAIDs, capsaicin, and pain-relieving creams.

Who can diagnose and treat osteoarthritis?

Arthritis can be managed by:

  • A family medicine physician.
  • An internist.
  • A nurse practitioner.
  • A physician assistant.
  • A rheumatologist.

Other health professionals may be part of the treatment team, such as:

  • A physiatrist.
  • A pain management specialist.
  • An orthopedic surgeon.
  • A physical therapist.
  • An occupational therapist.
  • A dietitian.
  • A social worker.

How can you care for yourself when you have osteoarthritis?

There are things you can do to manage the symptoms of arthritis and to help prevent the disease from getting worse. You can:

Use pain medicine.
If your pain is mild, over-the-counter medicines may help. These include nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen.
Make lifestyle changes.
These changes include getting enough rest, staying active, and staying at a healthy weight. Staying at a healthy weight is very important if you have arthritis in your legs or feet.
Use assistive devices.
Devices can take the stress and weight off your joints and make it easier for you to hold objects, open and close things, and walk. Devices may include a cane, a raised toilet seat, and large-handled utensils.
Try heat or cold on sore joints.
But don't use heat if the joint is swollen or hot.
Change how you do things.
Changes could include modifying your home, protecting your joints, and changing activities.

How is surgery used to treat osteoarthritis?

In most cases, people can manage their arthritis symptoms with medicine and lifestyle changes. But surgery may be an option if:

  • You have very bad pain.
  • You have lost a lot of cartilage.
  • You have tried medicine and other treatments, but they haven't helped.
  • Your overall health is good.

Surgery choices

Types of surgery for arthritis include:

Arthrodesis.

This joins (fuses) two bones in a damaged joint so that the joint won't bend. Doctors may use it to treat arthritis of the spine, ankles, hands, and feet. In rare cases, it's used to treat the knees and hips.

Arthroscopy.

This is sometimes tried to smooth a rough joint surface or remove loose cartilage or bone fragments. But in general it has not been shown to be helpful for arthritis.

Hip resurfacing surgery.

This is most often done in younger, more active people who have pain and disability caused by a badly damaged hip.

Joint replacement.

This is done when other treatments haven't worked and damage to the joint can be seen on X-rays. It involves surgery to replace the ends of bones in a damaged joint. The surgery creates new joint surfaces. The joints that are replaced most often are the hip, knee, and shoulder. But other joints such as the elbow and the ankle can also be replaced.

Osteotomy.

This is done to correct certain defects in the hip and knee. In most cases, it's done in active people younger than 60 who want to delay surgery to replace a hip or knee.

Small joint surgery.

Surgery is more common on the larger joints, such as the hip and knee. But if pain in the small joints of the hands or feet is so bad that the person can't use those joints, surgery may help.

How does osteoarthritis affect your social and emotional health?

Living with osteoarthritis can be stressful. You may worry about how it may change your life, work, and relationships.

It's hard to know how fast your arthritis may progress. Your symptoms may come and go, stay the same, or get worse over time. Some days you may feel fine and be able to do the things you need—and want—to do with little pain. Other days the pain may be too much for you to do simple tasks like getting dressed or brushing your teeth.

Some people feel overwhelmed, tired, and angry. They may be afraid that they might become disabled and not be able to care for themselves. They may even wonder if they can keep working. It's okay if you have any of these feelings. Most people who have arthritis feel this way at one time or another.

Some people with arthritis also feel down or depressed. They may describe this as feeling "depressed," "unhappy," "short-tempered," "blue," or "down in the dumps." If you feel like this most of the time, tell your doctor. Treating these symptoms may help you feel better and make it easier for you to do your daily tasks.

Finding ways to cope with osteoarthritis

Living with osteoarthritis can be stressful. But there are some simple things you can do to feel better and keep the joy in your life and relationships.

  • Ask your family and friends for help.

    Don't be afraid to let people help you with some of your tasks, especially on days when you have a lot of pain.

  • Balance your activity with rest.

    If you get tired when you do a task, break the task down into smaller tasks, and rest between them.

  • Learn ways to reduce stress.

    Stress can make your pain feel worse. You might try deep breathing and relaxation exercises or meditation to help reduce stress and relax your mind and muscles.

  • Meet with friends.

    At times, you may not want to go out because you're too tired or don't want to be seen using a cane or wheelchair. But being social can help you feel better. If you isolate yourself, you may get depressed.

  • See a counselor.

    Cognitive behavioral therapy teaches you how to express your fears and concerns. And it helps you learn new ways of coping with arthritis.

  • Be creative.

    Find ways to still do the things that you enjoy, but do them in a different way that doesn't cause pain. For example, plant flowers in a raised garden bed instead of planting them directly into the ground. Then you won't have to kneel.

  • Join a support group.

    This is a great place to share your concerns and hear how other people cope with the challenges of arthritis. Online forums and chat groups are also good places to find support.

  • Keep a pain diary.

    Write down how your moods, thoughts, sleep patterns, activities, and medicine affect your pain. Having a record of your pain can help you and your doctor find the best ways to treat your pain.

  • Educate yourself.

    The more you know about arthritis, the more you'll be able to cope with any lifestyle changes that you may need to make as your symptoms get worse. Encourage your family and friends to learn about arthritis too. Then they can know what you're dealing with and learn ways they can help you.

  • Stay positive.

    Adopting a "good-health attitude" and healthy habits, such as eating a balanced diet, staying at a healthy weight, and getting enough sleep, will make you feel better and help you stay active. When you think in a positive way, you may be more able to:

    • Care for yourself and handle the challenges of arthritis.
    • Avoid or cope with stress, anxiety, and depression.
  • Talk to your boss.

    If your arthritis makes it hard for you to do your job, talk to your boss. Discuss the changes you can make to your schedule and the things you can do to modify your work area. You might ask if:

    • You can have a later start time.
    • You can work part-time or work from home.
    • You can switch to a light-duty position, if your job involves a lot of lifting, bending, or standing.

If a family member or friend is helping to care for you, be sure to let that person know how grateful you are for the help. Keep in mind that your caregiver's life may be changing along with yours. And that person may be dealing with some of the same emotions as you. Talking is a great way for each of you to share your concerns and support for each other.

What puts you at risk for osteoarthritis?

You're more likely to have arthritis if:

You're overweight.
Extra weight adds stress on your joints and can change the normal shape of the joint.
You have or had a joint injury.
A single major injury to a joint or several minor injuries can cause cartilage damage over time.
You're not active.
Lack of exercise can cause your muscles and joints to get weak and stiff.
You have a family history of arthritis.
If someone in your family has arthritis, you may be more likely to have it too.

Other things that may put you at risk include:

Getting older.
Age isn't a direct cause of arthritis. But as you get older, you're more likely to have symptoms.
Loose or odd-shaped joints.
Knees that bend outward (bowleg) or knees that bend toward each other (knock knees), for example, can cause an imbalance in the joints because the cartilage wears down at an uneven rate.

Aerobic activity for osteoarthritis: Getting started

Aerobic exercise makes your heart and lungs stronger and builds your endurance.

Talk to your doctor before you start an exercise program or activity. Ask what kind of exercise is best for you and how to exercise if a joint is sore or swollen.

When you start an exercise program or activity, start slowly, and don't push yourself too hard. Pace yourself. For example, do 10 minutes of activity at a time, 1 or 2 times a day. Then work your way up to where you can do it for a longer time. Aim for at least 2½ hours of moderate activity a week. One way to do this is to be active 30 minutes a day, at least 5 days a week. Pacing yourself is especially important if you haven't exercised for a while.

There are many ways to get aerobic activity.

  • Walk as much as you can.

    You can walk outdoors through your neighborhood or on city paths. Or walk indoors on a treadmill or at the mall.

  • Work out in a pool.

    The water helps take the weight off painful joints, and it provides some resistance.

    • Try walking in water that is up to your waist or your chest.
    • Swim at your local health club, YMCA, or neighborhood pool. Many locations offer classes designed for people with arthritis.
  • Bike outdoors, or use an indoor bike.
  • Try an online video, or use an exercise app for smartphones.
  • Be more active in your daily routine.

    Doing vacuuming, housework, gardening, or yard work can all be aerobic.

Joints Often Affected by Osteoarthritis

Joints commonly affected by osteoarthritis

Osteoarthritis is a condition in which the cartilage that protects and cushions the joints breaks down over time. Eventually, the bones-formerly separated by the cartilage-rub against each other. This results in damage to the tissue and bone and causes painful joint symptoms.

Osteoarthritis, sometimes called degenerative joint disease or osteoarthrosis, is the most common form of arthritis. It most often affects the joints of the spine, fingers, thumbs, hips, knees, or toes.

What are the types of complementary medicine for osteoarthritis?

A lot of people use some form of complementary medicine to treat osteoarthritis. These treatments are often used along with standard care to help relieve their arthritis symptoms.

Some of these treatments may help you move more easily and deal with the stress and pain of arthritis. But in some cases, not much is known about how safe they are or how well they may work.

Be sure to tell your doctor about any complementary treatments you use or want to use. The doctor can tell you about the possible benefits and side effects of these treatments and whether these treatments may interfere with your standard care. For example, some diet supplements and herbal medicines may cause problems if you take them with another medicine.

Complementary treatments

Acupunctureand massage.

Some people find treatments like acupuncture and massage helpful for their knee arthritis. But they may not help any more than a placebo (fake treatment) does.

Mind-body practices.

Mind-body practices, such as yoga, tai chi, and qi gong, can help reduce stress and relax your mind and muscles. Stress can make pain worse. So learning to control stress and relax may help with pain.

Taping of the knee.

Taping uses tape that sticks to the knee to help keep the kneecap in place and relieve pain. You can do taping at home. But first have your doctor or physical therapist show you the right way to put it on.

Braces for the knee.

Braces can help shift weight off the part of your knee that hurts. It's not clear how well these work, but there isn't a lot of risk in trying them.

Transcutaneous electrical nerve stimulation (TENS).

TENS uses a mild electrical current to reduce pain.

Dietary supplements.

Many dietary supplements, such as glucosamine and chondroitin, have been tried. But there is not evidence that they help much with arthritis pain or stiffness. Turmeric is a supplement that is being studied and may have some benefit.

What causes osteoarthritis?

When you have arthritis, the cartilage that cushions and protects your joints breaks down and wears away. When it breaks down, the bones rub together and cause damage and pain. Experts don't know why this breakdown in cartilage happens.

In some cases, arthritis is caused by other conditions that damage cartilage.

What is osteoarthritis?

Osteoarthritis is the type of arthritis that many people get as they age. It happens when the cartilage that cushions your joints gradually breaks down and the bones rub against each other. This causes damage and pain. Osteoarthritis is usually called arthritis.

How do you use ice and heat for osteoarthritis?

For moderate to severe pain from osteoarthritis, try applying heat and cold to the affected joints. Experiment with heat and cold techniques until you find what helps you most.

You might try hot compresses or cold packs. You can also try switching between heat and cold.

  • Apply heat 2 or 3 times a day for 20 to 30 minutes to relieve pain and stiffness. But don't use heat if the joint is swollen or hot.
  • Put ice or a cold pack on your sore joint for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin.

Paraffin wax is a form of moist heat that may help if you have pain and stiffness in your hands or feet. It's especially useful before exercise. Your physical therapist can teach you to use wax at home.

After heat or cold treatments, try gentle massage for relaxation and pain relief.

Osteoarthritis: When to call

Call your doctor now or seek immediate medical care if:

  • You have sudden swelling, warmth, or pain in any joint.
  • You have joint pain and a fever or rash.
  • You have such bad pain that you cannot use a joint.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You have mild joint symptoms that continue even with more than 6 weeks of care at home.
  • You have stomach pain or other problems with your medicine.

How can physical therapy help osteoarthritis?

Physical therapy (PT) can help make daily tasks and activities easier. A physical therapist can help you with walking, grabbing and holding objects, or going up stairs. In PT, you also learn which types of exercises are best for you.

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